走路方案對急性骨髓性白血病病患接受化學治療期間疲憊改善之效果

Effects of walking program on decreasing fatigue in acute myelogenous leukemia patients receiving chemotherapy

張碧華(Pi-Hua Chang)

指導教授 ： 賴裕和

臺北醫學大學/護理學院/護理學研究所/碩士(2003年)

摘要

本研究目的在於確立走路方案改善急性骨髓性白血病病患接受化學治療期間疲憊之效果。研究設計採縱貫式重複測量之類實驗法，以方便取樣方式於中部某醫學中心，針對診斷為急性骨髓性白血病，且住院期間接受化學治療之病患，收案個數共15人，實驗組7人，控制組8人。收案時間為化學治療當日(化療前)、化學治療後第七天、第十四天及第二十一天，共四次。走路方案為每天走一次10分鐘，每週平均執行5天(含測試)，共三週，訓練期間之運動強度設在休息時每分鐘心跳加上30(HRresting+30)的範圍內。研究工具為12分鐘走路測試、簡明疲憊量表、症狀困擾量表、情緒狀態量表-焦慮及憂鬱次量表及生命徵象(含血壓、體溫、心跳及呼吸)之測量。所得資料以描述性統計、卡方檢定、t檢定、Shapiro-Wilk常態分佈檢定、雙/單因子重複測量變異數分析。研究結果顯示：(1)實驗組病患的12分鐘走路距離增加35%，控制組病患的距離減少26%；(2)實驗組病患的疲憊程度、疲憊干擾日常生活程度、症狀困擾及情緒障礙之改善效果皆較控制組佳。 本研究結果由於樣本數少，以致實驗組與控制組之差異未能呈現統計上之顯著意義。但與多數運動研究結果一致，亦即活動/運動在癌症治療期間的好處是不可磨滅的。因此，在臨床照護中，於此類住院病患接受化學治療期間，執行適當的走路活動可有助於降低疲憊。

關鍵字

急性骨髓性白血病 ； 化學治療 ； 走路方案 ； 12分鐘走路測試 ； 疲憊程度 ； 症狀困擾 ； 情緒障礙

並列摘要

The purpose of this pilot study is to examine the effects of walking program on reducing fatigue in acute myelogenous leukemia (AML) patients receiving chemotherapy. We used a longitudinal repeated-measure quasi-experimental research design for this study. The eligible subjects were AML patients who received chemotherapy. Patients were recruited using convenient sampling from a medical center in Middle Taiwan. Patients in the training group (n=7) had a 10-minute walk daily for 5 days a week (including test day) after chemotherapy. The training program continued for 3 weeks. The heart rate during training was controlled below the resting heart rate per minute plus 30 (HRresting + 30). 8 patients were in the control group. All patients were interviewed four times: on the first day of chemotherapy (before treatment), and on the 7th, 14th, and 21st day after chemotherapy. We used the following instruments to measure the variables: 12-min walking test, Brief Fatigue Inventory (BFI), Symptom Distress Scale- Chinese Modified Form (SDS-CMF), Profile of Mood States (POMS)- Anxiety and Depression subscales, and vital signs measurement. Data were analyzed using descriptive analyses, Chi-square test, t test, Shapiro-Wilk normality test, and two / one factor repeated measure ANOVA. The distance of 12-min walk increased 35% in the training group, and decreased 26% in the control group. The improving effects of the training group is better than that of the control group on the degree of fatigue, the degree of ADL interference of fatigue, symptom distress, and mood disturbance. Even though our data did not show a significant difference between the training and control groups due to the small sample size, we did find an agreement with most current exercise interventions studies supporting the benefits of activity/exercise during cancer treatment. In conclusions, proper walking activity may help to reduce fatigue while the cancer inpatients during chemotherapy.

並列關鍵字

acute myelogenous leukemia (AML) ； chemotherapy ； walking program ； 12-min walking test ； fatigue ； symptom distress ； mood disturbance

參考文獻

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